Placement of a caudal vena cava stent for treatment of Budd-Chiari–like syndrome in a 4-month-old Ragdoll cat

Hoehne, Sabrina N.; Milovancev, Milan; Hyde, Aleshia J; deMorais, Helio A; Scollan, Kate F; Nemanic, Sarah

doi:10.2460/javma.245.4.414

Cited by 12 publications

(6 citation statements)

References 20 publications

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“…Reports have described the use of vascular stents in the vena cava, left hepatic vein, pulmonary artery, pulmonic valve, and the right atrium in dogs. 22 , 23 , 24 , 25 , 26 , 27 Aortic trifurcation stenting has been performed in humans to treat patients with aortoiliac occlusive disease for over 30 years and is often accompanied by ancillary therapies such as systemic heparinization, local thrombolysis, and balloon angioplasty. 28 , 29 , 30 , 31 , 32 , 33 , 34 Prompt heparin anticoagulation at presentation improves outcomes in limb ischemia in humans by preserving microcirculation and preventing thrombus propagation.…”

Section: Discussionmentioning

confidence: 99%

“…Reports have described the use of vascular stents in the vena cava, left hepatic vein, pulmonary artery, pulmonic valve, and the right atrium in dogs 22‐27 . Aortic trifurcation stenting has been performed in humans to treat patients with aortoiliac occlusive disease for over 30 years and is often accompanied by ancillary therapies such as systemic heparinization, local thrombolysis, and balloon angioplasty 28‐34 .…”

Section: Discussionmentioning

confidence: 99%

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Stenting of the caudal aorta and aortic trifurcation for the treatment of thrombosis in 7 dogs

Gavin¹,

Weisse

Berent

2022

Veterinary Internal Medicne

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Background Aortic and aortoiliac thrombosis in dogs causes disease and death. Objective To describe the procedure and outcomes for stenting the caudal aorta and aortoiliac trifurcation. Animals Seven client‐owned dogs that underwent aortic/aortoiliac stenting for treatment of thrombosis. Methods Retrospective multi‐center investigation. Medical records were reviewed for dogs that underwent stenting of the aorta or aortoiliac trifurcation between 2008 and 2020. Information collected included history, signalment, clinicopathologic data, diagnostic imaging, procedure reports, and outcomes. Results Seven dogs with an occlusive thrombus located at or near the aortic trifurcation were included. Four of 7 dogs were non‐ambulatory. Hind limbs were paretic in 5 dogs, paralyzed in 1 dog, and claudication alone was noted in 1 dog. Five of the 7 dogs had protein‐losing nephropathy (PLN). Of 5 dogs with PLN, 1 had protein‐losing enteropathy (PLE) and controlled hypothyroidism and 1 had caudal aortic chondrosarcoma. Two dogs had no identified underlying disease. Angiography was performed before catheter directed thrombolysis and stent placement. No deaths occurred during the procedure. Postoperative complications included pain (4/7), bruising and edema (3/7), bruising only (1/7), and edema only (1/7). Median survival time (MST) of the 7 dogs was 264 days (range, 1‐1053 days). Five of 7 dogs were ambulatory within 2 days of stenting and survived to discharge with a MST of 425 days (range, 208‐1053 days). Conclusions and Clinical Importance Stenting of the aorta and aortoiliac trifurcation can provide an apparently safe and effective treatment with rapid return to ambulation for some dogs with aortic thrombosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Stenting of the caudal aorta and aortic trifurcation for the treatment of thrombosis in 7 dogs

Gavin¹,

Weisse

Berent

2022

Veterinary Internal Medicne

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“…The venous hypertension in patients with chronic obstruction of the CVC blood flow to the heart leads to a wide spectrum of signs, depending on the level of obstruction and the efficiency of the veno-venous collaterals. Endovascular stenting of the posthepatic CVC was reported in Budd-Chiari syndrome as palliative treatment in three dogs with malignant postsinusoidal venous outflow obstruction and in a kitten with web-like obstruction of the hepatic CVC [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Cava Stenting in a Dog with Symptomatic Azygos Continuation of the Caudal Vena Cava

Bertolini

Caldín

2020

Case Reports in Veterinary Medicine

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This report describes the successful placement of a nitinol stent within the azygos continuation of the caudal vena cava in a 2-year-old, neutered female, English Bulldog with clinical and imaging signs related to venous return chronic obstruction, renal venous thrombi, and chronic renal insufficiency. This noninvasive, interventional radiology procedure was safe and clinically effective for the patient. The clinical signs were rapidly eliminated, and three years later, the patient is still in good clinical condition, with normal renal function. Venous stenting appears to be a useful, new, minimally invasive treatment option for symptomatic cavo-azygos vascular connection.

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“…There is hepatic venous outflow obstruction and portal hypertension, leading to hepatomegaly and ascites. 1 , 17 , 18 Additionally, a dog with intrathoracic caudal vena cava obstruction also had impaired venous return to the heart, reduced cardiac output and renal blood flow, leading to secondary azotaemia. 19 This dog presented with more clinical findings including ascites, diarrhoea, lethargy, tacky mucous membranes, prolonged capillary refill time, a non-pulsatile left jugular vein and pitting oedema in the hindlimbs.…”

Section: Discussionmentioning

confidence: 99%

Caval foramen hernia in a cat

Siow

Hoon

Jenkins

et al. 2020

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 3-year-old neutered female domestic shorthair cat presented for a 2-week history of hyporexia, lethargy and weight loss. Aspartate aminotransferase, alanine aminotransferase and cholesterol were mildly elevated. Thoracic radiographs identified a lobulated soft tissue opacity in the caudal thorax to the right of midline, with the border effacing the caudal vena cava and broad-based towards the diaphragm. The broad base was suggestive of diaphragmatic hernia, with the other radiographic features and location suggestive of caval foramen hernia. Ultrasound confirmed diaphragmatic hernia with liver herniation. CT showed the herniation of multiple liver lobes and the gallbladder through a defect at the caval foramen. Herniorrhaphy was performed via ventral midline coeliotomy. Following this procedure, the cat’s clinical signs resolved and its weight has been regained. Relevance and novel information To our knowledge, this is the first report of successful caval foramen herniorrhaphy in a cat. Caval foramen hernia is a type of congenital diaphragmatic hernia. The authors suggest that its embryopathology involves defective septum transversum development. The case was detected during the standard diagnostic investigation of non-specific clinical signs. Its radiographic findings may easily be mistaken for a pulmonary mass. Although not seen in our case, caval foramen hernia is commonly associated with caudal vena cava obstruction, which can potentially result in Budd–Chiari-like syndrome.

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Placement of a caudal vena cava stent for treatment of Budd-Chiari–like syndrome in a 4-month-old Ragdoll cat

Cited by 12 publications

References 20 publications

Stenting of the caudal aorta and aortic trifurcation for the treatment of thrombosis in 7 dogs

Stenting of the caudal aorta and aortic trifurcation for the treatment of thrombosis in 7 dogs

Percutaneous Cava Stenting in a Dog with Symptomatic Azygos Continuation of the Caudal Vena Cava

Caval foramen hernia in a cat

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